Annual gynecological office visits commonly include routine urinalysis (u/a). We questioned the significance of this routine screening test and conducted a study at our NCI-designated comprehensive cancer center. Objective: To assess the efficacy of performing annual screening u/a to detect microhematuria in the non-symptomatic gynecologic cancer patient or the high-risk-for-cancer patient. Design: Women age 40 years and above presenting for annual gynecologic examination were screened by u/a prior to the pelvic exam. Patients identified with microhematuria were first assessed with a urine culture, and if negative, were referred to urology for an evaluation that included cystoscopy and/or radiographic studies such as CAT scans and renal ultrasounds. Results: Seven hundred and twenty nine (N = 729) asymptomatic patients, mean age 59 (range 40-90), were screened by u/a. Fifty five patients (7.6%) tested positive for microhematuria. Of these patients, seven had positive urine cultures and were treated successfully with antibiotics; five patients were currently menstruating, and repeat u/a were negative, and seven patients were lost to follow-up. Thirty-six had negative urine cultures and were referred for urologic evaluation. Of these patients, four had repeat negative u/a and refused further workup. Seven were lost to follow-up, and one was currently on chemotherapy and deferred follow-up. Urology evaluation was completed on 24 patients. Of these, 16 had unremarkable findings. Four had radiation or Cytoxan induced cystitis. Two had asymptomatic nephrolithiasis, one had a benign bladder polyp, and one had a persistent infection with accompanying hydronephrosis. Conclusion/Nursing Implications: Microhematuria found on routine u/a at annual gynecological examinations in women over 40 years yields little clinically significant diagnoses. This data indicates this test is unnecessary in the asymptomatic patient. Furthermore, it adds to patient cost and anxiety when referral is suggested. Oncology nurses in this setting now screen all patients for urinary symptoms and identify when it is appropriate to collect urine specimens at routine exams. This data leading to a change in nursing practice is valuable for all oncology nurses and should be considered in other patient care settings as well.

Repository Posting Date:

27-Oct-2011

Date of Publication:

27-Oct-2011

Conference Date:

2002

Conference Name:

27th Annual Oncology Nursing Society Congress

Conference Host:

Oncology Nursing Society

Conference Location:

Washington, D.C., USA

Note:

This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.
If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC Field

Value

Language

dc.type.category

Abstract

en_US

dc.type

Presentation

en_GB

dc.title

Annual Screening Urinalysis for Hematuria in Gynecological Patients Over Age 40: Efficient or Not?

Annual gynecological office visits commonly include routine urinalysis (u/a). We questioned the significance of this routine screening test and conducted a study at our NCI-designated comprehensive cancer center. Objective: To assess the efficacy of performing annual screening u/a to detect microhematuria in the non-symptomatic gynecologic cancer patient or the high-risk-for-cancer patient. Design: Women age 40 years and above presenting for annual gynecologic examination were screened by u/a prior to the pelvic exam. Patients identified with microhematuria were first assessed with a urine culture, and if negative, were referred to urology for an evaluation that included cystoscopy and/or radiographic studies such as CAT scans and renal ultrasounds. Results: Seven hundred and twenty nine (N = 729) asymptomatic patients, mean age 59 (range 40-90), were screened by u/a. Fifty five patients (7.6%) tested positive for microhematuria. Of these patients, seven had positive urine cultures and were treated successfully with antibiotics; five patients were currently menstruating, and repeat u/a were negative, and seven patients were lost to follow-up. Thirty-six had negative urine cultures and were referred for urologic evaluation. Of these patients, four had repeat negative u/a and refused further workup. Seven were lost to follow-up, and one was currently on chemotherapy and deferred follow-up. Urology evaluation was completed on 24 patients. Of these, 16 had unremarkable findings. Four had radiation or Cytoxan induced cystitis. Two had asymptomatic nephrolithiasis, one had a benign bladder polyp, and one had a persistent infection with accompanying hydronephrosis. Conclusion/Nursing Implications: Microhematuria found on routine u/a at annual gynecological examinations in women over 40 years yields little clinically significant diagnoses. This data indicates this test is unnecessary in the asymptomatic patient. Furthermore, it adds to patient cost and anxiety when referral is suggested. Oncology nurses in this setting now screen all patients for urinary symptoms and identify when it is appropriate to collect urine specimens at routine exams. This data leading to a change in nursing practice is valuable for all oncology nurses and should be considered in other patient care settings as well.

en_GB

dc.date.available

2011-10-27T12:04:10Z

-

dc.date.issued

2011-10-27

en_GB

dc.date.accessioned

2011-10-27T12:04:10Z

-

dc.conference.date

2002

en_US

dc.conference.name

27th Annual Oncology Nursing Society Congress

en_US

dc.conference.host

Oncology Nursing Society

en_US

dc.conference.location

Washington, D.C., USA

en_US

dc.description.note

This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.
If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

-

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